Hydration Innovation

Engaging people in the spring of technology

LGA Digital Showcase - 4.11.19 Dehydration in Care Homes: A National Issue

"Good hydration is a core element of care and plays a role in the prevention of avoidable harm associated with other known patient safety issues." - Caroline Lecko, NHS England Patient Safety Lead, July 2013

2015 cross-sectional study of >20,000 inpatient records: people admitted to hospital from care homes are 5 times more likely to be dehydrated than those admitted from home. Discovery Phase *Working together with residents and staff* Welcome to Sycamore Lodge

x 78 Nursing Dementia Residential Respite Day Care

Caroline Carter Registered Manager How can we help people drink enough?

1. Mission hydration innovation What, How and When are people actually drinking?
2. Don’t reinvent the water wheel? What is out there already?
3. ‘Spring’ into action! What do we need to learn?

Observation and insight Lead agency: Voluntary Action North Somerset

Expert interviews Lead agency: Project team

Data Lead agency: Shaw healthcare

I like a nice cup of tea in the morning For to start the day you see And at half past eleven Well my idea of heaven Is a nice cup of tea I like a nice cup of tea with me dinner And a nice cup of tea with me tea And when it's time for bed There's a lot to be said For a nice cup of tea

Insight Activities

Hydrations party – Building and using a hydration party trolley

Reminiscence - Music and pictures to prompt memories

## Insights

| Different flavours and colours | Drinking vessel is key | Offer a range of drinks | |-------------------------------|------------------------|-------------------------| | Can the environment encourage drinking | Good general understanding of hydration | Information about individual needs is key | | Individualised support | Staff need to be made aware of hydration risk | Reliable monitoring difficult to establish | Outcomes we would like to achieve:

- Reduced fractured neck of femur
- Reduced falls
- Reduced hospital admissions
- Shared best practice
- Increased staff satisfaction

All leading to increased Health and Wellbeing Eureka, then step back........................what is the hypothesis?

We believe......

• providing a choice to people will result in better hydration as they will be stimulated by a variety of flavours

• having subtle clues round the home will result in better hydration because of nudge theory

• that if staff are aware of the link between condition and hydration need this will result in better hydration because staff will have the knowledge to meet the need. Prototyping Activities

Matching game Music bingo Personalised cup holders Droplet

Ulla Smart Cup Hydration bottles Hydration app Using innovative technology to prompt hydration

Sycamore Lodge Hydration Initiative

@shawhealthcare f.shawhealthcare Prototyping with staff

“Great Idea”

“Really useful, particularly for agency staff”

“There should be one mobile device per unit”

“Residents could look at their own profile with staff”

“The app would free up time”

“If the app could monitor it could be used in handover so that staff would know immediately if a resident had drunk enough” Benefits to Sycamore Lodge

• Working in partnership with North Somerset, LGA, NHS digital and the CCG has proven a benefit to Sycamore Lodge as we have been able to share knowledge and be seen as an equal partner

• Promoting positive relationships between partners in contrast to usual working which is not always positive due to lack of understanding on both parts

• Working to one goal and being able to show how care homes can struggle to ensure everyone is hydrated due to service users different needs

• Better understanding of everyone's roles in all areas of the partnership

• Staff feeling their opinion is really valued by external professionals. Residents

• The hydration project focused staff over the very hot summer and it meant residents were well hydrated

• Residents have enjoyed taking part in the activities and had fun deciding on the theme and decorating the hydration trolley

• The project has encouraged residents to drink more and they have tried different drinks.

• We have been able to document a reduction in hydration related incidents (UTI, falls, confusion from dehydration) Sycamore Lodge team

- **Excited** and **enthused** the team to think outside of the box about hydration.
- Been encouraged to **think differently** about people with dementia participating in research.
- The team feel **valued** that their opinions and knowledge have been listened to.
- The team are carrying on with parts of the research which they felt **made a difference** – e.g. the hydration trolley, trying different drinks using games to discuss hydration. Residents and Staff Reflections

Elizabeth

Marjorie

Amazing staff Success is........

- Co design
- Collaboration
- Outcomes Final thoughts

• Collaboration and codesign with staff and residents lead to understanding individuals needs

• Proactive assessment is key to dehydration prevention

• Using information from these assessments to form personal profiles within the app supports carers to place the individual at the heart of improving hydration

• There is so much talk about the impact of dehydration across health and social care sectors, let’s take action instead